Cardiopulmonary resuscitation in patients with out-of-hospital cardiac arrest (OHCA) is associated with poor prognosis. Because the COVID-19 pandemic may have impacted mortality and morbidity, both on an individual level and the health care system as a whole, our purpose was to determine rates of OHCA survival since the onset of the SARS-CoV2 pandemic. We conducted a systematic review and meta-analysis to evaluate the influence of COVID-19 on OHCA survival outcomes according to the PRISMA guidelines. We searched the literature using PubMed, Scopus, Web of Science and Cochrane Central Register for Controlled Trials databases from inception to September 2021 and identified 1775 potentially relevant studies, of which thirty-one articles totaling 88,188 patients were included in this meta-analysis. Prehospital return of spontaneous circulation (ROSC) in pre-COVID-19 and COVID-19 periods was 12.3% vs. 8.9%, respectively (OR = 1.40; 95%CI: 1.06–1.87; p < 0.001). Survival to hospital discharge in pre- vs. intra-COVID-19 periods was 11.5% vs. 8.2% (OR = 1.57; 95%CI: 1.37–1.79; p < 0.001). A similar dependency was observed in the case of survival to hospital discharge with the Cerebral Performance Category (CPC) 1–2 (6.7% vs. 4.0%; OR = 1.71; 95%CI: 1.35–2.15; p < 0.001), as well as in the 30-day survival rate (9.2% vs. 6.4%; OR = 1.63; 95%CI: 1.13–2.36; p = 0.009). In conclusion, prognosis of OHCA is usually poor and even worse during COVID-19.

This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.

BackgroundCatheter-directed therapies (CDT) are an alternative to systemic thrombolysis (ST) in pulmonary embolism (PE) patients, but the mortality benefit of CDT is unclear.ObjectiveWe conducted a systematic review with meta-analysis to compare the efficacy and safety of CDT and ST in intermediate-high and high-risk PE.MethodsWe included (P) participants, adult PE patients; (I) intervention, CDT; (C) comparison, ST; (O) outcomes, mortality, complications, in-hospital treatment, and length of hospital stay; (S) study design, randomized controlled trials (RCTs), or cohort comparing CDT and ST. The primary endpoint was 30-day mortality. Secondary outcomes included treatment-related complications including bleeding, the use of hospital resources, and length of hospital stay.ResultsEleven studies including 65,589 patients met the inclusion criteria. Thirty-day mortality was lower in the CDT group, compared to ST group [7.3 vs. 13.6%; odds ratio (OR) = 0.51, 95% confidence interval (CI) 0.38–0.69, p &lt; 0.001]. The rates of myocardial injury, cardiac arrest, and stroke were lower in CDT group, compared to ST group (p &lt; 0.001 for all). The rates of any major bleeding, intracranial hemorrhage, hemoptysis, and red blood cell transfusion were lower in patients treated with CDT, compared to ST (p ≤ 0.01 for all). Extracorporeal life support was used more often in patients treated with CDT, compared to ST (0.5 vs. 0.2%, OR = 2.52, 95% CI 1.88–3.39, p &lt; 0.001). The use of hospital resources and length of hospital stay were comparable in both groups.ConclusionCDT might decrease mortality in patients with intermediate-high and high-risk PE and were associated with fewer complications, including major bleeding.

Background Statin use in many studies is related to the improvement of a patients’ condition including reducing the risk of various malignancies. Herein, is a systematic review and meta-analysis to examine the evidence on the association between statin therapy and the risk of the occurrence of pancreatic cancer, mainly in terms of decreased risk of developing pancreatic cancer among patients using statin therapy in the long-term perspective. Methods PubMed, Web of Science, Scopus and Cochrane Central Register of Controlled Trials (CENTRAL) were searched from database inception to December 1 st , 2021. Random effect models were used to estimate summary odds ratios (OR) and the corresponding 95% confidence intervals (CI). Results A total of 26 studies comprising 2,797,186 patients were included. Polled analysis showed that pancreatic cancer occurrence in statin vs. no-statin group varied and amounted to 0.4% vs. 0.6% (OR = 0.83; 95% CI: 0.72–0.96; I 2 = 84%; p = 0.01). Conclusions In summary, the present analysis shows that overall statins use is significantly associated with a reduction in risk of pancreatic cancer. However, these results were not confirmed for the randomized controlled trial subgroup. Further prospective studies are needed to confirm the current results.

The aim of the study was to assess mortality trends due to falls in early (65–74 years) and late (75+) old age groups in Poland in 2000–2020. The study used a database of all deaths due to falls in two age groups. Per 100,000 men in early old age, the crude death rate (CDR) increased from 25.3 in 2000 to 25.9 in 2020. After 2012, a statistically significant decrease was observed (annual percentage change (APC) = −2.3%). Similar trends were noted for standardized death rates (SDR). Among men 75 years and older, the CDR values between the years 2000 and 2005 decreased (APC = −5.9%; p < 0.05), while after 2005, they increased (1.3%; p < 0.05). The SDR value decreased from 160.6 in 2000 to 118.1 in 2020. Among women aged 65–74, the CDRs values between 2000–2020 decreased from 13.9 and 8.2 per 100,000 women. The SDR value decreased from 14.0 to 8.3, respectively (2000–2007: APC = −7.2%; p < 0.05). Among women aged 75+, the CDR value decreased from 151.5 to 111.6 per 100,000 but after 2008, they began to increase (APC = 1.9%; p < 0.05). SDR decreased from 188.9 to 98.0 per 100,000 women. Further research on the mortality in falls is needed in order to implement preventive programs.

Łódź odznacza się najwyższym poziomem zaawansowania procesu starzenia i najwyższymi wartościami negatywnych mierników stanu zdrowia w kraju. Rodzi to konieczność podejmowania intensywnych, wielosektorowych i spójnych działań wobec osób starszych, również w obszarze aktywizacji. Celem artykułu jest ocena opinii mieszkańców województwa łódzkiego na temat potrzeb z zakresu aktywizacji społecznej seniorów. W badaniu przeprowadzonym w 2020 roku wzięło udział 235 mieszkańców województwa łódzkiego. Narzędzie badawcze stanowił anonimowy kwestionariusz ankiety, udostępniony w formie elektronicznej. W analizie statystycznej wykorzystano wskaźniki struktury, miary z zakresu statystyk opisowych i analitycznych – współczynnik korelacji, test niezależności χ2 oraz test U Manna‑Whitneya. Za najatrakcyjniejsze zajęcia skierowane do seniorów ponad jedna trzecia respondentów uznała zajęcia artystyczne, a co czwarty badany wymienił warsztaty z zakresu technologii informacyjnych. Blisko połowa badanych wskazała festyny i imprezy międzypokoleniowe jako najbardziej istotne wydarzenia aktywizujące seniorów. Ośmiu na dziesięciu respondentów widziało potrzebę inicjowania działań z zakresu integracji międzypokoleniowej. Mieszkańcy większych miast częściej niż osoby zamieszkujące wsie i średnie miasta wskazywali na udział seniorów w dedykowanych im wydarzeniach (p < 0,05). Jako bariery korzystania z usług senioralnych mieszkańcy większych miast najczęściej wymieniali brak informacji, a pozostali respondenci problemy z transportem (p < 0,05). Potwierdzono potrzebę inicjowania działań integrujących pokolenia oraz zajęć edukujących seniorów w obszarze nowych technologii. Wzrost kompetencji cyfrowych wśród osób starszych mógłby przyczynić się do zwiększenia ich samodzielności, a tym samym do poprawy komfortu życia seniorów i ich opiekunów.

Mitral valve dysfunction affects around 2% of the population and its incidence is still increasing, making it the second most common valvular heart disease, after aortic stenosis. Depending on the etiology of the disease, it can be classified into primary or secondary mitral regurgitation. The first line of treatment is optimal medical therapy. If ineffective, mitral valve intervention can be considered. For patients disqualified from surgical treatment, transcatheter edge-to-edge repair with the use of MitraClip may be considered. Over 100,000 MitraClip procedures have been performed which makes this the most established transcatheter technique for the treatment of severe mitral regurgitation. The aim of this review is to discuss the technical details of the MitraClip procedure, clinical evidence regarding the efficacy of MitraClip, complications related to the clip implantation alongside with acute complications based on the currently available evidence and clinical experience.

No abstract